A comparative study on the predictive effect of two different scales on intraoperatively acquired pressure injuries

Abstract:

Objective: To compare the predictive validity and the consistency of the modified Munro pressure ulcer risk assessment scale（Munro scale） and Scott triggers（ST） for adult perioperative surgical patients. Methods: A case-control study was conducted involving 270 patients who underwent surgery in The Second Affiliated Hospital of Chongqing Medical University from 2017 to 2019. Their general data and surgical data were collected. A total of 45 patients diagnosed with intraoperatively acquired pressure injuries were taken as the case group，and according to the same operation period，225 patients without intraoperatively acquired pressure injuries were selected as the control group by the 1∶5 paring method. We used the modified Munro scale and ST to score and record respectively，and the area under the curve（AUC） was calculated，as well as the Jordan index，sensitivity，specificity，positive predictive value（PPV），negative predictive value（NPV） and κ value of the scale. Results: The Munro scale scores of the case group and the control group were （29.870±3.279） points and （26.460±3.381） points，respectively，and the ST scores were （2.361±0.900） points and （1.650±0.989） points，respectively. The AUC of the Munro scale was 0.764（95%CI=0.692-0.873），and the best diagnostic limit，sensitivity，specificity，PPV，NPV were 28.500，0.667，0.720，0.248，0.934，respectively. And the AUC of ST was 0.691（95%CI=0.610-0.772），and the best diagnostic limit，sensitivity，specificity，PPV，NPV were 1.500，0.822，0.502，0.289，0.923，respectively. The κ value of the two scales was 0.497，with significant difference（P<0.05）. Conclusion: Both of the modified Munro scale and the ST can effectively evaluate the risk of intraoperatively acquired pressure injuries in surgical patients，with a moderate consistency. In the clinical practice，it’s feasible to use the modified Munro scale and the ST to evaluate the risk of intraoperatively acquired pressure injuries in surgical patients before operation，which is worth popularizing.